The head of the Centers for Medicare and Medicaid Services said she doubted that spending more money to advertise Obamacare would result in higher enrollment.
The Trump administration spent $10 million advertising Obamacare during the 2017 open enrollment, a major drop from the $100 million the Obama administration had spent the year before.
CMS Administrator Seema Verma told reporters Tuesday that lower enrollment may have involved other factors, including the prices of plans for customers who don’t receive federal subsidies to reduce the cost of coverage.
During the last open enrollment, the number of customers fell by roughly 5 percent, from 9.2 million to 8.7 million, for healthcare.gov, the federal exchange that 39 states use.
“I think we actually had a very successful open enrollment … [the decrease] could have been because of the increases in the rates,” Verma said. “I’m not sure that at this point where we are with Obamacare, with the high rates, with the limited networks, with the lack of choices, that we can spend a whole bunch of money on advertising and that is going to bring people into the program.”
The prices of some plans increased because President Trump ended payments to insurers, known as cost-sharing subsidies, and because the people who enrolled in the plans were sicker than expected, which causes prices to rise for the whole pool. Many states made changes to what insurers could offer, however, which resulted in plans for people who receive subsidies being less expensive than in previous years.
Critics of the administration have pointed to additional factors that may have reduced enrollment. The Trump administration reduced spending on navigators and shortened the amount of time during which people could sign up for coverage, from three months to six weeks. Congressional Republicans repealed the fine for not having health insurance starting in 2019, which may have caused confusion among consumers.
Verma said it wasn’t unusual to reduce spending on advertising for programs over time, noting that spending on Medicare, a program that covers more than 58 million people, is $10 million.
“Over time it’s natural to reduce expenditures in terms of outreach and enrollment … when programs have been out there for a while they don’t necessarily require the same level of investment in terms of outreach and advertising,” she said.
Residents in 11 states receive coverage through a state exchange. California, for instance, spent $110 million on advertising and outreach, and its overall enrollment dropped by 2.3 percent, though new enrollees entered the program at higher levels than in previous years. The executive director of the California exchange, Covered California, has urged the federal government to spend $400 million on advertising.
